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Chunk #47 — Discussion — Limitations of the review

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Structural and functional imaging studies in chronic cannabis users: a systematic review of adolescent and adult findings.
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Results presented here have pointed out some important methodological differences that limit the generalisation of results and comparison between studies and have doubtless contributed to the slightly disparate array of findings. Despite the use of a strict definition of chronic cannabis user and robust application of inclusion and exclusion criteria in an attempt to avoid excessive heterogeneity between samples, studies often diverged on certain socio-demographic characteristics and cannabis use parameters, such as gender-bias, age of onset, lifetime use and abstinence period before the acquisition of imaging data. Moreover, it is well known that the THC content of smoked cannabis varies markedly between sources and preparations, with potency reported to have increased substantially over the past ten years [2]. Thus, comparability of earlier to later studies may not always be appropriate [44]. Furthermore, the exclusion of studies involving recreational and naïve cannabis users implies that the question of whether the brains of these subjects are adversely affected by cannabis is not addressed within the framework of the present review. Another important confounding factor is the inclusion of subjects with concurrent use